Pelvic Floor Prolapse – What Every Woman Needs to Know... And Act Upon

Pelvic floor prolapse only occurs in women.

It happens when the pelvic floor -- a hammock of muscles and connective tissues stretching across the floor of the pelvis -- weakens and descends, causing the pelvic organs (bladder, uterus, vagina and rectum) to drop and protrude into the wall of the vagina.

Some women who suffer a pelvic floor prolapse do not have any symptoms. But many do. The most common sign is a feeling of heaviness or pressure in the area of the vagina, or a sensation of 'something coming down below'.

While men can also suffer from pelvic floor disorders, women are especially vulnerable because they have delicate reproductive organs (vagina and uterus) and their pelvic floor is more flexible to allow for childbirth.

Our hearts go out to women because so many things can go wrong when their pelvic floor weakens and can no longer support the pelvic organs.

(The Five Main Types of Pelvic Floor Prolapse.)

The following note from a young woman about her mother reflects the great anguish, pain and suffering that women go through when they suffer a pelvic floor prolapse:

"My mom has some type of tissue falling out of her vagina. She thinks it is her bladder... Her hysterectomy (surgery to remove the womb) was at 45 years old and she also gave birth to 10 children.

She is the primary caretaker of my 40 year old sister dying of colon cancer and promised me she will take care of this when life is some what normal again. What do you think about this?

My dad said he has seen tissue with blood. When I asked her, she said no. I'm afraid she wouldn't tell me for worry."

Another heart-rending note from a woman who suffered a pelvic floor prolapse (of the uterus):

"I am a 51 year old woman who has had 2 pregnancies, delivered vaginally with no real complications. I did experience a couple of things in my pregnancies that I think contributed to my current uterine prolapse.

I am one of ten kids, my mother has no problems. My oldest sister had a hysterectomy in her early 30's and now has some urinary incontinence which I believe is related to weakened vaginal walls. My youngest sister is 34 and has a seriously prolapsed uterus.

We have both been told by our gyn's that hysterectomy to correct prolapse will lead, eventually, to a weakening of the ligature that suspends the bladder and further weakening of the pelvic floor muscles.

This will undoubtedly lead to prolapsed vaginal walls. Pessary is not a viable option, it doesn't do the job. I am looking for any help and information I can get."

A pessary is a small device made of latex or silicone that comes in many different shapes and sizes. It is inserted into the vagina to hold the prolapsed organ(s) in place. It is a stop-gap measure. Once fitted, a pessary must be removed and cleaned with soap and water every month.

Something must be done about it. When a woman suffers a pelvic floor prolapse, her life can literally turn upside down. It is not just the dropping of the rectum, bladder, uterus or vagina.

When the pelvic floor weakens and descends, the pudendal nerve can suffer from stretch injury... If it is damaged, a woman can experience loss of bladder and bowel control, pelvic and back pain, and sexual problems.

Like many other colon-related ailments, the incidence of pelvic floor prolapse in Western countries has reached epidemic proportions. The statistics and facts are frightening:

  • More than 50% of women age 50 and older suffer from one or more problems caused by pelvic floor prolapse

  • One in nine Caucasian women (11%) will have surgery for pelvic floor prolapse or urinary incontinence before the age of 80

Yet, in sharp contrast, in the developing world, pelvic floor prolapse is rarely seen:

"...African and Asian women seem to be relatively unaffected (by pelvic floor problems)."

-- Schulz, J.A. (2001), Assessing and Treating
Pelvic Organ Prolapse
; Ostomy Wound
Management, 4 (5), 54-56, 58-60

"Prolapse appears to be comparatively uncommon in much of the developing world, despite the much greater multi-parity (having many children) of its mothers ..."

-- Primary Surgery, Volume One: Non-trauma,
Chapter 11 -- Prolapse of the Uterus)

Many doctors and gynecologists are baffled by this. However, there is a simple explanation for the high incidence of pelvic floor prolapse among women in the Western world: sitting toilets.

Unlike their counterparts in the West, women (and men) in Asia, Africa and Middle East still perform their bodily functions (including childbirth) in the squatting position.

By squatting for waste elimination, a woman would not dislodge her pelvic floor and organs as a result of having to perform the Valsalva Maneuver -- the practice of holding one's breath, and straining and pushing downwards with the diaphragm.

By preventing the use of the proper posture for evacuation, the sitting toilet makes it physically impossible for users to evacuate waste easily and effectively because the colon, which is designed with squatting in mind, is in the continence mode.

Dr F.A. Hornibrook, in his 1993 book The Culture of the Abdomen, had warned against the use of sitting toilets:

"Man's natural attitude during [elimination] is a squatting one, such as may be observed amongst field workers or natives. Fashion, in the guise of the ordinary water closet, forbids the emptying of the lower bowel in the way Nature intended.

Now in this act of [elimination] great strains are imposed on all the internal organs..."

Likewise, Dr H. Aaron also wrote about the importance of squatting and disadvantages of using a sitting toilet in his book "Our Common Ailment" published in 1938:

"When the thighs are pressed against the abdominal muscles in this position, the pressure within the abdomen is greatly increased, so that the rectum is more completely emptied.

Our toilets are not constructed according to physiological requirements. Toilet designers can do a good deal for people if they will study a little physiology and construct seats intended for proper [elimination]."

The truth is that trying to empty the bowels in the sitting position is like driving a car without releasing the parking brakes. In frustration, and in an attempt to force waste out, one has to hold the breath and strain to push downwards with the diaphragm forcefully. Over time, it can cause a pelvic floor prolapse.

The amount of straining in the sitting position is at least three times more than in a squatting position. This was one of the findings by Dr B. A. Sikirov, the Israeli physician who did extensive clinical research on the effect of squatting on hemorrhoid patients in 1987.

The pelvic floor is not designed to cope with this type of stress. Over time, the muscles, connective tissues and supporting ligaments of the pelvic floor weaken. Gradually, it descends more and more… to a point when it can no longer support and hold up the pelvic organs.

Chiropractor Dr William Welles, in his article The Hidden Crime of the Porcelain Throne (unpublished article), did not minced his words when he described his thoughts about the sitting toilet:

"The design of the modern-day toilet was created with absolute disregard for the anatomy of the human body.

On the conventional Western toilet, pressure is exerted inside the abdomen by pushing the diaphragm down in such a way as to push all the organs of the body downwards, causing them to sag (pelvic floor prolapse), and creating dysfunction of the ileocecal valve.

The abdominal muscles are left totally unsupported, as we have said, and the body suffers the consequences."

Up to today, the medical establishment has utterly ignored and kept silent about the connection between sitting toilets and pelvic floor prolapse.

There could only be one explanation: medical practice relating to pelvic floor prolapse and other disorders is a lucrative business:

  • The average cost for a hysterectomy (removal of the womb) can be as high as $17,000

  • The annual cost for hysterectomies in the US exceeds $5 billion

  • The cost of surgical management of genital prolapse is more than $10 billion per year in the United States alone

Dr H Aaron Educating women (and men) about the health threat posed by sitting toilets and the benefits of squatting for bowel movements would go a long way to eradicate the scourge of pelvic disorders. But this would also mean the end of a multi-billion dollar industry.

To be fair, the medical establishment cites "frequent straining during bowel movements" as a possible cause.

But there is no explanation why there is a need for straining in the first place -- the use of the sitting posture when passing stools.

Things are not going to improve anytime soon. The pain and suffering will not go away because sitting toilets are too entrenched in Western society. Increasingly, sitting toilets are also displacing 'primitive' squatting toilets in countries whose peoples have traditionally used the squatting position for waste elimination.

Find Out More...

How Squatting Protects Against Pelvic Floor Prolapse

In the squatting position, a woman does not need to exert and strain as the colon is prepared and aligned for quick expulsion of waste. Instead of pushing downwards with the lungs, she 'pushes' upwards with the thighs, in the following way:

The right thigh helps to seal the colon and pushes wastes in the cecum upwards into the ascending colon.

The left thigh supports and pushes up the sigmoid colon to open up the natural kink where it joins the rectum, making it easy for waste to flow to the rectum.

sigmoid colon, kink in sigmoid colon

At the rectum, squatting also relaxes the puborectalis muscle to straighten the pathway to the anus so that waste could pass out easily and freely.

The sitting toilet ignores all above natural requirements of waste elimination. The straining and pushing downwards stresses and progressively weakens the pelvic floor.

It is shame so many women have to endure so much pain and suffering, because they are not aware of the underlying cause of the growing epidemic of pelvic floor disorders.

As with all other illnesses, the best option is to prevent pelvic floor prolapse in the first place… simply by squatting for bowel movements. However, if you have been using sitting toilets for many years, you might find it difficult to squat, as explained on this page on squatting facets.

Having to squat may seem daunting, but it can be done. With regular practice, you can regain the ability to do so, and reap the benefits it brings.

You can experience easier and comfortable waste evacuation without the need to strain. Moreover you would protect yourself against pelvic floor prolapse.

I wish to share with you a real-life case that can provide hope to countless millions of women who suffer pelvic floor prolapse.

Dr. Akilah El, ND, PhD, is a naturopath with a deep understanding (and personal experience) of gynecologic pathology.

In 1991, while she was still a student, she was diagnosed with cervical cancer and uterine fibroids. Ignoring the dire warnings of her gynecologist, she cured herself without the use of drugs, surgery or radiation.

A key factor in her recovery was the adoption of the squatting posture for elimination. This relieved the pressure on the pelvic floor and allowed the pudendal nerve to repair itself. In this way, the pelvic organs were reconnected to the central nervous system -- the energy and intelligence that protects us from disease.

Dr. Akilah has repeatedly verified the effectiveness of this simple lifestyle change in helping her patients resolve gynecological ailments. The results have convinced her that "98% of all hysterectomies are unnecessary and dangerous."

Book Recommendation

book about squatting, Nature Knows Best
If you want to have a better understanding of why the use of sitting toilets has such a detrimental impact on a woman's pelvic health, I would recommend that you read Nature Knows Best.

[More information about Nature Knows Best...]

The Heart of The Matter

When it comes to pelvic floor prolapse, the best strategy for protection is prevention -- simply by choosing to squat for bowel movements.

There are two things you would need in order to do this. You must be able to squat. And you need a squatting toilet. But if you don't have a squat toilet, there are four ways in which you can 'convert' your sitting toilet to a 'squatting' one.

Of the four options, the most practical one, in many cases, would be to use a toilet squatting platform or converter.

Find Out More...

Additional Reading

The Roadmap To Colon Health

Go from Pelvic Floor Prolapse to Home Page.

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